PEBC MCQ Compounding, Product Preparation & Inventory question: year old with juvenile idiopathic arthritis

PEBC MCQCompounding, Product Preparation & Inventory

A technician needs to prepare an oral suspension from methotrexate 2.5 mg tablets for a 6 year old with juvenile idiopathic arthritis who cannot swallow tablets. Which precaution is most appropriate?

a. Prepare it in a containment device with hazardous-drug PPE
b. Use a mortar reserved for methotrexate, with standard dispensing gloves
c. Crush the tablets on a dedicated counter wearing a mask and single gloves
d. Prepare it in the regular compounding area and wash all equipment afterwards

Show the answer and explanation

Answer: a. Prepare it in a containment device with hazardous-drug PPE

Methotrexate is on the NIOSH list of hazardous drugs, and crushing tablets generates hazardous dust. NAPRA's standards require hazardous preparations to be made with containment (a ventilated containment device in an appropriate room) and hazardous-drug PPE (two pairs of chemotherapy gloves, a protective gown and, as assessed, eye and respiratory protection). Dedicated equipment, a mask or cleaning afterwards do not prevent exposure during preparation. Source: NAPRA Model Standards for Pharmacy Compounding of Non-sterile Preparations (2018), hazardous preparations; NIOSH List of Hazardous Drugs in Healthcare Settings (2024).

Common mistake

Treating hazardous oral drugs like ordinary tablets when manipulating them.

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Original practice material written to the public PEBC blueprint; not a past or real exam question. Not affiliated with or endorsed by The Pharmacy Examining Board of Canada (PEBC). Educational practice material for exam preparation only. Not medical advice and not a substitute for current product monographs, clinical guidelines or professional judgement. Questions have not yet been reviewed by a licensed pharmacist.